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Botulism is not common but is a serious illness resulting from eating improperly preserved or canned food or form entrance of the Clostridium botulinum bacterium through an open wound. Clostridium botulinum is found in soil and in water that is untreated and is found throughout the world. It makes spores that can survive in improperly cooked, canned or preserved food, where they make a toxin. The toxin is what causes botulinum and it usually takes a very little amount of botulinum toxin to lead to severe problems with botulism poisoning.

Most botulism results from contamination with home-made vegetables that are canned improperly or from poorly cured ham and pork, smoked fish, raw fish, honey and corn syrup. It can also enter open wounds from contact with the soil.

Infants can get botulism by eating spores that grow within the child's gastrointestinal tract. Babies should not eat honey or corn syrup unless it is in something that is well cooked. Infants beyond a year of age can take these things in without difficulty in most cases. Some normal infants can shed the botulism organism in their stool. Botulism happens in 110 individuals within the US per year. Most of these are infants who take in honey or corn syrup.

Symptoms of botulism occur 8 to 36 hours after consuming contaminated food. There is generally no associated fever. Symptoms in adults include difficulty breathing, respiratory failure, abdominal cramps, difficulty swallowing, difficulty speaking, dry mouth, double vision, nausea and vomiting, and weakness with total body paralysis which is equal with regard to the sides of the body affected.

In infants, signs of botulism include constipation, weakness or loss of muscle tone, poor feeding with a weak suck, a weakened cry, respiratory distress and an alertness which is out of proportion to the weakness.

There are tests the doctor can use to diagnose botulism. These include noting that there is a lack of a gag reflex and absent deep tendon reflexes. The eyelids might droop from paralysis. There may be paralysis of the bowel on x-ray, loss of feeling or muscle function, speech problems and an inability to urinate with a full bladder. There are also blood tests available that can detect the presence of the botulinum toxin. A stool culture can grow out Clostridium botulinum. Lab tests can be done on the suspected food as well so that the botulinum toxin can be identified.

The treatment of botulism is largely supportive. You need to be in a hospital with preparations for ventilator support if you can't breathe on your own. A tube may be put in so that your airway remains patent. A ventilator is used if your oxygenation diminishes while in the hospital due to loss of breathing support. There is a botulinum antitoxin available that can get rid of the toxin from your body.

IV fluids are used whenever you can't swallow well due to the presence of the toxin. In some cases, a feeding tube can be inserted to feed you liquid nutrition if you cannot eat on your own. Doctors need to report cases of botulism to the state health authorities or to the US CDC so that if there is contaminated food that can get to others, it is removed from store shelves. Antibiotics might need to be used but it doesn't work in all cases against the Clostridium organism because it is the toxin that is the real problem.

The prognosis of botulism is excellent if treatment is given. Untreated botulism has the tendency to lead to death, especially if there is a lot of toxin in the system.

Complications of botulism include the risk of getting aspiration pneumonia, having weakness which is long lasting, having respiratory distress and having problems with the nervous system for at least a year.

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